First line tests |
To confirm hyperandrogenaemia and exclude significant hyperprolactinaemia, thyroid disease or premature ovarian failure
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Testosterone, SHBG, prolactin, thyroid function tests, FSH
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Follow up tests (in order) |
Only instigate if testosterone is >4 nmol/L (after solvent extraction if methodology suspect – see text)
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1) To investigate extent of hyperandrogenaemia and provide supportive evidence for late onset congenital adrenal hyperplasia (CAH) or Cushing’s syndrome. |
Androstenedione, DHEAS, 17-OHP, urinary free cortisol.
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2) To diagnose CAH |
Only instigate if 17-OHP is >6 nmol/L
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Serum 17-OHP before and 60 mins after Synacthen (250 ug i.v.)
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Urinary steroid profile
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3) To diagnose androgen secreting tumour |
These tumours are not common; only perform test if no other explanation for significantly elevated testosterone
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Serum testosterone before and after 48h low dose (2 mg/day) dexamethasone
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Urinary steroid profile
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